Medical operation device

ABSTRACT

A medical operation device is attachable to an insertion portion of a medical instrument for observation. The medical operation device includes: rotary cylinder rotatably disposed in device main body that has insertion portion inserting hole through which insertion portion is inserted; insertion portion pressing member that presses insertion portion inside rotary cylinder; insertion portion mounting section cover provided inside insertion portion inserting hole that prevents insertion portion directly touching inner face of insertion portion inserting hole, vicinity of opening of insertion portion inserting hole, and insertion portion pressing member; switching instruction portion that switches whether insertion portion pressing member presses insertion portion to specify state where rotary cylinder and insertion portion are united and state where insertion portion moves forward/rearward with respect to rotary cylinder; and rotation mechanism that, when rotary cylinder and insertion portion are united, rotates rotary cylinder to rotate insertion portion unified with rotary cylinder around insertion portion axis.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a medical operation device that isattached to an insertion portion of a medical instrument for observationand that has excellent workability and operability.

2. Description of the Related Art

In recent years, medical endoscopes have been used which performobservation of a diseased part or the like inside a body by inserting along and narrow insertion portion into the body and which, as necessary,can perform various kinds of therapeutic treatment using a treatmentinstrument that is passed through the inside of a treatment instrumentchannel.

In this kind of endoscope, to improve the insertability to a curved siteand to enable an observation optical system or the like that is providedat a distal end portion to be directed in a desired direction, forexample, a bending portion that bends vertically and laterally isprovided at the distal end side of the insertion portion. Further, whenintroducing the insertion portion into a target site within the body, inaddition to performing an operation that bends the bending portion, asurgeon also performs an operation that twists the insertion portion.

For example, U.S. Patent Application Publication No. 2007-0100201A1discloses an endoscope system in which, while grasping the insertionportion of an endoscope, the surgeon can easily execute variousfunctions of a treatment instrument that is inserted through a treatmentinstrument channel of the endoscope or various functions of theendoscope. In this endoscope system, an operation instructing device isdisclosed that allows a surgeon to operate a bending knob with a handthat grasps the operation portion of the endoscope, and in addition tooperating the insertion portion with the hand that grasps the insertionportion, the surgeon can also operate the various respective functionsof the endoscope and a treatment instrument with that hand. Further, inthis endoscope system, the operation instructing device is united withthe insertion portion by operating a fixed lever.

Furthermore, Japanese Patent Application Laid-Open Publication No.2003-140055 discloses an endoscope apparatus in which holding of aninsertion portion can be easily and securely performed with a hand thatgrasps an operation portion or a remote control. In this endoscopeapparatus, an insertion portion is passed through an insertion portioninserting section of an insertion portion holding tool and a remotecontrol is provided at a mounting portion. In this state, bystrengthening or relaxing a force that grasps the insertion portionholding tool, the surgeon can easily switch between a state in which theinsertion portion is fixed to the remote control and a state in whichthe insertion portion can freely move forward or backward with respectto the remote control. A bending lever comprising a bending operationswitch that the surgeon operates when bending a bending portion of theinsertion portion is provided in the remote control of the endoscopeapparatus. Thus, the surgeon can perform an operation that bends thebending portion with the hand that grasps the insertion portion.

Thus, according to the above described operation instructing device, itis possible for the surgeon to release a hand from the operationinstructing device. In contrast, although it is not possible for thesurgeon to release a hand from the insertion portion holding tool, afixed state and a state of forward/rearward movement are easilyobtainable. However, the above described operation instructing deviceand insertion portion holding tool are provided directly on theinsertion portion. Therefore, with respect to the operation instructingdevice or the insertion portion holding tool, it is necessary to enablea fixed state or a state of forward/rearward movement to be easilyobtainable in a condition in which the surgeon can release their hands,and also to prevent adherence of body fluid or dirt that adheres to theinsertion portion at a mounting section with the insertion portion.

SUMMARY OF THE INVENTION

A medical operation device of the present invention is a medicaloperation device that is attachable to an insertion portion of a medicalinstrument for observation. The medical operation device includes arotary cylinder, an insertion portion pressing member, an insertionportion mounting section cover, a switching instruction portion, and arotation mechanism. The rotary cylinder is rotatably provided on thedevice main body. The rotary cylinder includes an insertion portioninserting hole through which the insertion portion is inserted. Theinsertion portion pressing member presses the insertion portion that isdisposed inside the rotary cylinder. The insertion portion mountingsection cover is arranged inside the insertion portion inserting holeand prevents the insertion portion directly touching an inner face ofthe insertion portion inserting hole, the insertion portion directlytouching the vicinity of an opening of the insertion portion insertinghole, and the insertion portion directly touching the insertion portionpressing member. The switching instruction portion switches whether ornot the insertion portion pressing member presses the insertion portion.The switching instruction portion issues an instruction to enter a statein which the rotary cylinder and the insertion portion are united, and astate in which the insertion portion moves forward/rearward with respectto the rotary cylinder. The rotation mechanism rotates the rotarycylinder when the rotary cylinder and the insertion portion are unitedto cause the insertion portion that is united with the rotary cylinderto rotate around the axis of the insertion portion.

The above and other objects, features and advantages of the inventionwill become more clearly understood from the following descriptionreferring to the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a view that illustrates an endoscope system;

FIG. 2 is a side surface view of an electric bending operation device asa medical operation device;

FIG. 3 is a rear view of the electric bending operation device;

FIG. 4 is a sectional view illustrating the configuration inside arotary cylinder of the electric bending operation device;

FIG. 5 is a view illustrating the configuration of an insertion portionmounting section cover;

FIG. 6 is a view illustrating a state in which an electric bendingoperation device and an insertion portion that is inserted through aninsertion portion inserting hole of the electric bending operationdevice are integrally fixed together;

FIG. 7 is a view illustrating another configuration of the insertionportion mounting section cover;

FIG. 8 is a view illustrating an electric bending operation device thatincludes an insertion portion mounting section cover according toanother configuration;

FIG. 9 is a view illustrating a different configuration of the insertionportion mounting section cover;

FIG. 10 is a view illustrating a state in which the electric bendingoperation device is covered with the insertion portion mounting sectioncover according to the different configuration;

FIG. 11 is a view illustrating another configuration of the electricbending operation device;

FIG. 12 is a view illustrating the configuration of an insertion portionmounting mechanism of the electric bending operation device;

FIG. 13 is a view illustrating a protrusion and insertion portionpressing members that are provided in the protrusion;

FIG. 14 is a view illustrating the relation between a switching cylinderand insertion portion pressing members;

FIG. 15 is a view illustrating the configuration of an insertion portionmounting section cover that also serves as an insertion portion pressingmember;

FIG. 16 is a view that illustrates an electric bending operation deviceaccording to a second embodiment, that illustrates the configuration ofan insertion portion mounting mechanism provided with an insertionportion mounting section cover that also serves as an insertion portionpressing member;

FIG. 17 is a view illustrating the configuration of an electric bendingoperation device as a third embodiment of the present invention;

FIG. 18 is a sectional view along a line XVIII-XVIII shown in FIG. 17;

FIG. 19 is a view illustrating a drape;

FIG. 20 is a view illustrating a drape winding section in which a drapeis wound by a predetermined amount around the insertion portion;

FIG. 21 is a view illustrating a drape in a state in which the drape ispasted to the insertion portion; and

FIG. 22 is a view that describes a state in which the drape windingsection is arranged in the device main body that is in an open state.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Hereunder, embodiments of the present invention are described withreference to the drawings.

The first embodiment is described below referring to FIG. 1 to FIG. 6.

As shown in FIG. 1, an endoscope system 1 of the present embodimentincludes an electric bending endoscope 2, an endoscope control device 3,a display device 4, an electric bending operation device 5 that is anoperation device, and an insertion portion mounting section cover(hereunder, abbreviated as “cover”) 6.

The electric bending endoscope 2 is a medical instrument forobservation, and includes an insertion portion 11 that is insertedinside the body, an operation portion 12 that is provided on theproximal end side of the insertion portion 11, and a universal cord 13that extends from the operation portion 12. The proximal end portion ofthe universal cord 13 is connected to the endoscope control device 3.The endoscope control device 3 is provided with an illumination portion,an image processing portion, control portions 3 a and 3 b, and the like.The illumination portion includes a power supply portion that suppliespower to a light emitting device such as an LED or an illumination lampthat emits an illuminating light from an illumination window of a distalend portion 14, described later, of the electric bending endoscope 2.The image processing portion includes a drive circuit that drives asolid-state image pickup device such as a CCD or a CMOS that is housedin the distal end portion, and an image processing circuit thatgenerates video signals from image signals that are generated byphotoelectric conversion at the solid-state image pickup device andtransmitted to the image processing circuit. Video signals that aregenerated at the image processing circuit of the image processingportion are outputted to the display device 4 and displayed asendoscopic images on a screen 4 a.

The insertion portion 11 is configured by the distal end portion 14, anelectric bending portion 15, and a flexible tube portion 16 that areprovided in a linked manner in this order from the distal end side. Theelectric bending portion 15 of the present embodiment, for example,includes a first bending portion 17 and a second bending portion 18. Thefirst bending portion 17 and the second bending portion 18 include aplurality of bending pieces (not shown) that are rotatably connected ina predetermined direction and bend vertically and laterally. Distal endportions of angle wires for the top, bottom, left and right arerespectively provided in a fixed condition at positions corresponding tothe top, bottom, left and right of a tip piece (not shown) that ispositioned at the extreme tip of each of the bending portions 17 and 18.

According to the present embodiment, the electric bending portion 15includes the first bending portion 17 and the second bending portion 18that bend the electric bending portion 15 vertically and laterally.However, the electric bending portion 15 is not limited to thisconfiguration, and a configuration may be adopted that includes only thefirst bending portion 17, or in which the second bending portion 18bends vertically, or which includes bending portion that bendsvertically and laterally or bends vertically as a third bending portion.

On one side surface or another side surface of the operation portion 12are arranged a first bending portion operation section 21 and a secondbending portion operation section 22. The first bending portionoperation section 21 includes, for example, a first vertically bendingknob 23UD and a first laterally bending knob 23RL that are rotatablyprovided on the same axis. The second bending portion operation section22 includes a second vertically bending knob 24UD and a second laterallybending knob 24RL that are rotatably provided on the same axis.

The bending portions 17 and 18 are bent, for example, downward byrotating the vertical knobs 23UD and 24UD clockwise as viewed from theposition of the surgeon. Further, the bending portions 17 and 18 arebent, for example, upward by rotating the vertical knobs 23UD and 24UDcounter-clockwise. Meanwhile, when the lateral knobs 23RL and 24RL arerotated clockwise, the bending portions 17 and 18 bend to the right, andwhen the lateral knobs 23RL and 24RL are rotated counter-clockwise, thebending portions 17, 18 bend to the left.

On a longitudinal side surface 19 that is sandwiched between one sidesurface and the other side surface are provided an air/water supplybutton 25, a suction button 26, and a plurality of buttons 27 forperforming various operations such as switching the display of thedisplay device 4 or issuing an instruction to freeze or release adisplay image. Further, a treatment instrument insertion opening 28 forintroducing a treatment instrument into a treatment instrument channelis provided in the operation portion 12.

Inside the operation portion 12 of the electric bending endoscope 2 areprovided, for example, a first vertically bending motor (not shown), afirst laterally bending motor (not shown), a second vertically bendingmotor (not shown), and a second laterally bending motor (not shown). Thefirst vertically bending motor pulls and slackens an up angle wire and adown angle wire of the first bending portion 17. The first laterallybending motor pulls and slackens a left angle wire and a right anglewire of the first bending portion 17. The second vertically bendingmotor, meanwhile, pulls and slackens an up angle wire and a down anglewire of the second bending portion 18. The second laterally bendingmotor pulls and slackens a left angle wire and a right angle wire of thesecond bending portion 18.

Inside the operation portion 12 is provided an unshown knob encoder thatdetects a rotation amount and a rotation direction, respectively, of theknobs 23UD, 23RL, 24UD, and 24RL. When any of the knobs 23UD, 23RL,24UD, and 24RL is rotated clockwise or counter-clockwise by a surgeon orthe like, the knob encoder outputs a knob rotation control signal thatindicates the rotation direction and the rotation amount of therespective knobs to a bending control portion 3 a that is a first drivecontrol portion of the endoscope control device 3.

Simultaneously with the input of a rotation control signal, the bendingcontrol portion 3 a calculates the pulling amount of an angle wire by awire drive motor that corresponds to the rotation control signal, andoutputs a bending control signal to the corresponding wire drive motor.Thereupon, the wire drive motor corresponding to the knob operationperformed by the surgeon is driven and the electric bending portion 15performs a bending operation as illustrated, for example, by the dashedlines.

The electric bending operation device 5 as a medical operation device ismounted to the insertion portion 11 of the electric bending endoscope 2for use. The insertion portion 11 is inserted through an insertionportion inserting hole 50 a of the electric bending operation device 5.The electric bending operation device 5 principally includes aninsertion portion operation section 30 and an insertion portion mountingmechanism 50. A rotation mechanism 70 is arranged in the insertionportion mounting mechanism 50. Reference numeral 37 denotes a supportcolumn that unites the insertion portion operation section 30 and theinsertion portion mounting mechanism 50.

The cover 6 includes a covering portion for an inner face of aninserting hole (hereunder, abbreviated as “hole covering portion”) 6 a,rotary portion side surface covering portions (hereunder, abbreviated as“side surface covering portions”) 6 b, and a fixing portion 6 c. Thecover 6 prevents body fluid or the like that adheres to the insertionportion 11 that is inserted inside the body from adhering to theinsertion portion mounting mechanism 50 of the electric bendingoperation device 5.

The insertion portion operation section 30 will now be describedreferring to FIG. 2, FIG. 3, and FIG. 4.

In the present embodiment, a direction indicated by an arrow X in FIGS.2 and 3 is taken as the distal end direction and the opposite directionthereto is taken as the proximal end direction. Further, a directionindicated by an arrow Y is taken as the left direction and the oppositedirection thereto is taken as the right direction. Furthermore, adirection indicated by an arrow Z is taken as the upward direction andthe opposite direction thereto is taken as the downward direction.

As shown in FIGS. 2 to 4, the insertion portion operation section 30includes a first knob portion 31, a second knob portion 32, and twistingoperation buttons 35. According to the present embodiment, the insertionportion operation section 30 is attached to an operation portion supportmember 34 via a fixed rod 33.

The first knob portion 31 corresponding to the first bending portionoperation section 21 provided in the operation portion 12 of theelectric bending endoscope 2, and the second knob portion 32corresponding to the second bending portion operation section 22 arearranged, for example, in the X direction on a left side surface 33L ofthe fixed rod 33.

The twisting operation buttons 35 include a button 35L and an unshownbutton 35R that indicate a twisting direction. The buttons 35L and 35Rare arranged, for example, in the Y direction on the top surface of thefixed rod 33.

The first knob portion 31 includes a first vertically bending knob 31UDand a first laterally bending knob 31RL that have the similar functionsas the first vertically bending knob 23UD and the first laterallybending knob 23RL. The second knob portion 32 includes a secondvertically bending knob 32UD and a second laterally bending knob 32RLthat have the similar functions as the second vertically bending knob24UD and the second laterally bending knob 24RL.

Inside the fixed rod 33 is provided an unshown knob encoder that detectsa rotation amount and a rotation direction, respectively, of the knobs31UD, 31RL, 32UD, and 32RL. When any of the knobs 31UD, 31RL, 32UD, and32RL is rotated clockwise or counter-clockwise by a surgeon or the like,the knob encoder outputs a knob rotation control signal that indicatesthe rotation direction and the rotation amount of the respective knobsto the bending control portion 3 a that is the first drive controlportion of the endoscope control device 3.

Simultaneously with the input of a rotation control signal from any ofthe knobs 31UD, 31RL, 32UD, and 32RL, the bending control portion 3 acalculates the pulling amount of an angle wire by a wire drive motorthat corresponds to the rotation control signal, and outputs a bendingcontrol signal to the corresponding wire drive motor. Thereupon, thewire drive motor corresponding to the knob operation is driven such thatthe electric bending portion 15 performs a bending operation.

The buttons 35L and 35R indicate the rotation direction and rotationamount of an insertion portion rotation motor (denoted by referencenumeral 73 in FIG. 3 as described later). While the button 35R or 35L isbeing pressed down, a twisting control signal is outputted to thetwisting control portion 3 b that is a second drive control portion ofthe endoscope control device 3. The button 35L outputs a twistingcontrol signal that rotates the insertion portion 11 in the leftwarddirection, and the button 35R outputs a twisting control signal thatrotates the insertion portion 11 in the rightward direction.

Simultaneously to the input of a twisting control signal, the twistingcontrol portion 3 b outputs a twisting operation signal that actuatesthe insertion portion rotation motor.

The fixed rod 33 is integrally fixed to the distal end side of theoperation portion support member 34 by, for example, a screw 39 a. Theoperation portion support member 34 also serves as a grasping portion,and a proximal end portion 34 a thereof is integrally fixed to thesupport column 37 by, for example, a screw 39 b. The longitudinal axisof the operation portion support member 34 and the X axis of theelectric bending operation device 5 are set in a parallel relationship.

Note that, signal wires that extend from the twisting operation buttons35, the first knob portion 31, and the second knob portion 32,respectively, are passed through the inside of a protective tube 38 thatextends from the proximal end portion 34 a of the operation portionsupport member 34 and connected to the endoscope control device 3.

Next, the insertion portion mounting mechanism 50 that includes therotation mechanism 70 is described referring to FIG. 2 to FIG. 4.

First, the insertion portion mounting mechanism 50 is described.

As shown in FIG. 2 to FIG. 4, the insertion portion mounting mechanism50 principally includes a rotation holding portion 51, a rotary cylinder52 that also serves as the rotation mechanism 70, an insertion portionmounting section cover 6, an air bag 53, and a lever 54. Referencenumerals 55 and 56 denote lids. The lids 55 and 56 include openings 55 oand 56 o that forms the insertion portion inserting hole 50 a. The lids55 and 56 are fixed to the rotary cylinder 52, and forms the distal endface and proximal end face of the rotary cylinder 52, respectively.

The rotation holding portion 51 is the device main body, and includes athrough-hole 51 h as shown in FIG. 4. A bearing 7 is provided inside thethrough-hole 51 h. A rotary portion 52 a of the rotary cylinder 52 isrotatably retained by the bearing 7.

As shown in FIG. 3, a lever mounting portion 51 a and a support columnmounting portion 51 b are provided in the rotation holding portion 51. Alever supporting member 57 is fixed by screwing in the lever mountingportion 51 a.

As shown in FIG. 3 and FIG. 4, the lever supporting member 57 includes apair of supporting portions 57 a that are vertically arranged. A fulcrumportion 54 a of the lever 54 is disposed between the supporting portions57 a. The fulcrum portion 54 a is rotatably attached to the supportingportions 57 a by a first pin 69 a. As a result, the lever 54 moves froma position indicated by a solid line to a position indicated by a dashedline as a switching instruction portion.

Reference numeral 58 denotes a plate spring. The lever 54 is disposed atthe position indicated by the solid line by the urging force of theplate spring 58. Reference numeral 59 denotes, for example, a proximityswitch. When the lever 54 that is the switching instruction portion isdisposed at the position indicated by the dashed line against the urgingforce of the plate spring 58, the proximity switch 59 outputs an “on”signal to the endoscope control device 3. Upon input of the outputsignal from the proximity switch 59, the endoscope control device 3switches an electromagnetic valve 8 c, described later; from a gassupply state to an atmosphere release state. Thereafter, when the lever54 is moved to the position indicated by the solid line by the urgingforce of the plate spring 58, the proximity switch 59 is switched to an“off” state. Thereupon, the electromagnetic valve 8 c is again switchedto a gas supply state.

The rotary cylinder 52 includes a hollow portion 52 b and an insertionportion introduction hole 52 c. The insertion portion introduction hole52 c is a through-hole that forms the insertion portion inserting hole50 a, and links the hollow portion 52 b and the outside. In the presentembodiment, the hollow portion 52 b is an air bag installation hole.

The air bag 53 as an insertion portion pressing member is made with anelastic member such as rubber. The air bag 53 includes amounting/demounting hole 53 a. The air bag 53 is a tube element that isformed in a so-called pipe shape. At a solid portion of the pipe shapeis provided a fluid chamber 53 b that comprises a single space so as tocover the circumference of the mounting/demounting hole 53 a.

An unshown mouthpiece with a check valve is connected to the fluidchamber 53 b. The inside of the fluid chamber 53 b is normally set to aforward/rearward movement enabling pressure that is a pressure at whichthe insertion portion 11 can smoothly move forward and rearward insidethe mounting/demounting hole 53 a. When the pressure of the fluidchamber 53 b is the forward/rearward movement enabling pressure, themounting/demounting hole 53 a functions as the insertion portioninserting hole 50 a.

Nitrogen gas, for example, is supplied to the fluid chamber 53 b via asupply tube 8 b that links, for example, a supply port 8 a provided on awall of an operating room and a connection mouthpiece. Theelectromagnetic valve 8 c is arranged partway along the supply tube 8 b.The electromagnetic valve 8 c is configured to be capable of switchingbetween a gas supply state that supplies nitrogen gas to the fluidchamber 53 b and an atmosphere release state in which nitrogen gas ofthe fluid chamber 53 b is released to the atmosphere.

The air bag 53 is expanded by nitrogen gas being supplied into the fluidchamber 53 b of the air bag 53. As the air bag 53 is expanded in a statein which the air bag 53 is housed inside the hollow portion 52 b, thehole diameter of the mounting/demounting hole 53 a gradually becomessmaller.

When the insertion portion 11 is inserted into the mounting/demountinghole 53 a while the air bag 53 is in an expanded state, the amount of apressing force that presses the insertion portion 11 gradually increasesalong with the expansion of the air bag 53. The pressure inside thefluid chamber 53 b then reaches a fixing pressure that places theinsertion portion 11 and the electric bending operation device 5 in astate in which they are integrally fixed to each other and, as shown inFIG. 6, the air bag 53 enters a state in which the air bag 53 is inintimate contact with the inner face of the hollow portion 52 b and theinsertion portion 11. At this time, the insertion portion 11 and therotary cylinder 52 provided with the air bag 53 enter a state in whichthey are integrally fixed together.

Note that, the pressure inside the fluid chamber 53 b is monitored viaan unshown pressure gauge that is provided partway along the supply tube8 b. The endoscope control device 3 controls the supply of nitrogen gasbased on a detection signal that is outputted from the pressure gauge.When the endoscope control device 3 confirms that an “on” signal isoutputted from the proximity switch 59 upon the lever 54 being operated,the endoscope control device 3 switches the electromagnetic valve 8 c toan atmosphere release state. Thereupon, nitrogen gas inside the fluidchamber 53 b is released into the atmosphere by the elastic force of theair bag 53 to decrease the pressure of the fluid chamber 53 b to theforward/rearward movement enabling pressure. Meanwhile, when the lever54 is returned to the solid line position from the dashed line position,the output of an “on” signal from the proximity switch 59 stops.Thereupon, the endoscope control device 3 switches the electromagneticvalve 8 c to a gas supply state again. As a result, the pressure insidethe fluid chamber 53 b increases and changes to the fixing pressure.

The rotation mechanism 70 will now be described.

As shown in FIG. 2 and FIG. 3, the rotation mechanism 70 principallyincludes a cylinder gear 71 provided in the rotary cylinder 52 and aninsertion portion rotation motor 73 that is provided in a motor housing72 that is integrally fixed to the rotation holding portion 51. Theinsertion portion rotation motor 73 generates a driving force thatrotates the rotary cylinder 52.

The cylinder gear 71 is provided on the outer circumference of therotary portion 52 a of the rotary cylinder 52 that protrudes from thethrough-hole 51 h of the rotation holding portion 51. The cylinder gear71 is a cylinder side spur gear 71 a that has a parallel tooth tracewith respect to the central axis of the rotary cylinder 52. A motor sidespur gear 74 that meshes with the cylinder side spur gear 71 a isfixedly provided on a motor shaft 73 a of the insertion portion rotationmotor 73.

According to this configuration, the rotary cylinder 52 rotates withrespect to the rotation holding portion 51 upon a rotational drivingforce of the insertion portion rotation motor 73 being transferred tothe cylinder side spur gear 71 a via the motor shaft 73 a and the motorside spur gear 74. At this time, if the rotary cylinder 52 comprisingthe air bag 53 and the insertion portion 11 are integrated together, theinsertion portion 11 is rotated accompanying rotation of the rotarycylinder 52.

Note that, to prevent the rotary cylinder 52 from performing an idlerotation with respect to the insertion portion 11, the endoscope controldevice 3 determines whether or not a pressure inside the fluid chamber53 b is equal to or greater than a threshold value when a twistingcontrol signal is outputted from the button 35L or 35R. The endoscopecontrol device 3 then controls the driving of the insertion portionrotation motor 73 based on the determined result. More specifically,when the pressure inside the fluid chamber 53 b is equal to or greaterthan the threshold value, while the surgeon is operating the button 35Lor 35R, the insertion portion rotation motor 73 is driven and theinsertion portion 11 performs a twisting operation.

The cover 6 illustrated in FIG. 5 is an elastic member that is made of aresin or rubber. The hole covering portion 6 a comprising the cover 6 isformed in a pipe shape having a through-hole 6 d, and has apredetermined rigidity. The external diameter dimensions of the holecovering portion 6 a are set to be smaller than the diameter of theinsertion portion inserting hole 50 a taking into account theinsertability into the insertion portion inserting hole 50 a. Meanwhile,the diameter dimensions of the through-hole 6 d are set to be greaterthan the diameter of the insertion portion 11 taking into account theinsertability of the insertion portion 11.

In this case, the term “predetermined rigidity” refers to a flexibilitythat can prevent buckling when pushing the hole covering portion 6 ainto the insertion portion inserting hole 50 a and also convey apressing force of the air bag 53.

The hole covering portion 6 a is provided inside the insertion portioninserting hole 50 a that includes the mounting/demounting hole 53 a, theinsertion portion introduction hole 52 c, and openings 55 o and 56 o ofthe lids 55 and 56. The insertion portion 11 is inserted inside thethrough-hole 6 d of the hole covering portion 6 a that is providedinside the insertion portion introduction hole 52 c.

The side surface covering portions 6 b are thin-walled, circular flangesthat are provided at both side sections of the hole covering portion 6a. The external diameter dimensions of the side surface coveringportions 6 b are set to be greater than the diameter of the proximal endface and the distal end face of the rotary cylinder 52. The side surfacecovering portions 6 b have a flexibility that allows the side surfacecovering portions 6 b to bend as indicated by the dashed lines in thefigure. The side surface covering portions 6 b are bent at the edges ofthe proximal end face and the distal end face of the rotary cylinder 52such that edge portions 6 e thereof are disposed at the outer peripheralface of the rotary cylinder 52.

The flexible side surface covering portions 6 b are also capable ofbending along the peripheral face of the hole covering portion 6 a or offolding so as to be housed inside the through-hole 6 d. When disposingthe cover 6 inside the insertion portion inserting hole 50 a of theelectric bending operation device 5, the side surface covering portions6 b are bent so as to be disposed along the peripheral face of the holecovering portion 6 a.

A fixing portion 6 c is provided in the vicinity of the edge portion 6 eof each side surface covering portion 6 b. The fixing portion 6 c is,for example, a belt shape. A hook and loop fastener 6 f constituting amounting/demounting portion is provided at the front surface of one endside that is fixed to the side surface covering portion 6 b of thebelt-shaped fixing portion 6 c, and at the rear surface of the other endthereof.

In a state in which bent edge portions 6 e are disposed at the outerperiphery of the rotary cylinder 52, the side surface covering portions6 b cover the proximal end face and the distal end face of the rotarycylinder 52. The side surface covering portions 6 b are integrally fixedto the rotary cylinder 52 by winding the belt-shaped fixing portion 6 caround the edge portions 6 e of the side surface covering portions 6 band matching together the hook and loop fasteners 6 f.

The action of the endoscope system 1 including the electric bendingoperation device 5 configured as described above will now be described.

When using the electric bending operation device 5, first, the userattaches the cover 6 to the insertion portion inserting hole 50 a of theelectric bending operation device 5. At that time, the user bends theside surface covering portions 6 b of the cover 6 to align the sidesurface covering portions 6 b with the peripheral face of the holecovering portion 6 a.

Next, the user inserts the cover 6 from an opening at one end of theinsertion portion inserting hole 50 a towards an opening at the otherend. The user causes a folding portion (see reference numeral 6 g inFIG. 5) of the side surface covering portion 6 b to protrude from theopening at the other end of the insertion portion inserting hole 50 a.Thereafter, the user returns the bent side surface covering portion 6 bto a flange shape.

Subsequently, the user bends the respective side surface coveringportions 6 b to dispose the edge portion 6 e at the outer peripheralface of the rotary cylinder 52. Thereafter, the user winds thebelt-shaped fixing portion 6 c and matches together the hook and loopfastener 6 f. As a result, the cover 6 is attached in a predeterminedstate to the electric bending operation device 5 as shown in FIG. 6.

Next, the user inserts the insertion portion 11 of the electric bendingendoscope 2 into the insertion portion inserting hole 50 a from theproximal end side of the electric bending operation device 5 on whichthe cover 6 is mounted. More specifically, the user inserts theinsertion portion 11 into the through-hole 6 d of the cover 6 from theinsertion portion introduction hole 52 c side.

Next, when the user determines that the electric bending operationdevice 5 has reached a predetermined position of the flexible tubeportion 16, the user connects a second supply tube 8 d to the connectionmouthpiece to put the device in a nitrogen gas supply state.

Thereupon, nitrogen gas is supplied into the fluid chamber 53 b toexpand the air bag 53. When the pressure inside the fluid chamber 53 breaches the fixing pressure, an inner face 53 d of themounting/demounting hole 53 a of the air bag 53 presses the insertionportion 11 via the hole covering portion 6 a of the cover 6. As aresult, the rotary cylinder 52 comprising the air bag 53 and theinsertion portion 11 are unified.

In this case, the surgeon inserts the insertion portion 11 into the bodywhile, for example, observing an endoscopic image that is displayed onthe screen 4 a of the display device 4. At this time, the surgeonoperates the lever 54 of the electric bending operation device 5 toperform operations that change the relative positions of the insertionportion 11 and the electric bending operation device 5, rotates thefirst knob portion 31 and the second knob portion 32 of the insertionportion operation section 30 to perform operations to bend the electricbending portion 15, and presses the buttons 35L and 35R of the twistingoperation buttons 35 to perform operations to twist the insertionportion 11.

More specifically, the surgeon gradually moves the insertion portion 11by repeatedly performing operations to insert and withdraw the insertionportion 11 in a state in which the lever 54 is disposed at the positionindicated by the solid line, operations to hold the lever 54 at theposition indicated by the dashed line and change the position of theelectric bending operation device 5 with respect to the insertionportion 11, and operations to again insert and withdraw the insertionportion 11 in a state in which the lever 54 is disposed at the positionindicated by the solid line.

Further, when releasing a hand from the lever 54 to insert the insertionportion 11 into the body, the surgeon operates the first knob portion 31and the second knob portion 32, or the buttons 35L and 35R of theoperation buttons 35. When the surgeon operates the first knob portion31 and the second knob portion 32, the first bending portion 17 and thesecond bending portion 18 of the electric bending portion 15 bend inaccordance with the operations of the first knob portion 31 and thesecond knob portion 32. When the surgeon operates the button 35L or 35R,the rotary cylinder 52 is rotated and the insertion portion 11 that isunited with the rotary cylinder 52 is twisted in a directioncorresponding to the button operation.

When an endoscopic image of the target site is displayed on the screen 4a of the display device 4, the surgeon carries out an inspection,insertion of a treatment instrument, a biopsy or the like. After theinspection or treatment is completed, the surgeon withdraws theinsertion portion 11 from inside the body.

Thereafter, the user pulls out the insertion portion 11 from theinsertion portion inserting hole 50 a of the electric bending operationdevice 5 that is covered with the hole covering portion 6 a of the cover6. Further, after detaching the hook and loop fasteners 6 f and removingthe side surface covering portions 6 b from the rotary cylinder 52, theuser withdraws the cover 6 from the insertion portion inserting hole 50a of the electric bending operation device 5.

Thus, the configuration is one in which an air bag is provided as aninsertion portion pressing member in the electric bending operationdevice that integrally fixes together the electric bending operationdevice and the insertion portion, and in which the supply of nitrogengas to the fluid chamber of the air bag and the release of nitrogen gasfrom inside the air bag is performed by a lever operation. According tothis configuration, a surgeon can easily switch between a state in whichthe insertion portion and the electric bending operation device areintegrally fixed together and a state in which the electric bendingoperation device moves forward or rearward with respect to the insertionportion by appropriately performing a lever operation of the electricbending operation device.

The air bag having a mounting/demounting hole and a fluid chamber isprovided in a hollow portion of the rotary cylinder. The air bag isexpanded in a state in which the insertion portion is inserted into themounting/demounting hole by supplying nitrogen gas to the inside of thefluid chamber. Thus, since substantially the entire circumference of theinsertion portion that is disposed inside the rotary cylinder is pressedby the air bag, the insertion portion and the air bag can be integrallyfixed together in a rigid condition.

The insertion portion mounting section cover comprises the hole coveringportion and side surface covering portions that are provided at bothside portions of the hole covering portion. When using the electricbending operation device, the cover is attached in a predeterminedstate, the insertion portion inserting hole is covered with the holecovering portion of the cover, and the side surface of the rotarycylinder that is the vicinity of the opening of the insertion portioninserting hole is covered with the side surface covering portion. It istherefore possible to prevent the distal end face and the proximal endface of the rotary cylinder comprising the electric bending operationdevice that is mounted in a condition allowing forward/rearward movementon the insertion portion, and the insertion portion inserting hole thatare inserted into the body from being contaminated by the insertionportion to which dirt or the like adheres. Accordingly, by replacingonly the cover after completing an endoscopic examination, the electricbending operation device can be continuously used.

Furthermore, the hole covering portion comprising the cover is made witha flexibility that enables the hole covering portion to be pushed intothe insertion portion inserting hole, and the side surface coveringportions are formed in a circular flange shape with thin walls having aflexibility that allows the side surface covering portions to bend. Itis thus possible to bend the flexible side surface covering portionsalong the peripheral face of the hole covering portion, and easilydispose the hole covering portion along which the side surface coveringportions are bent inside the insertion portion inserting hole of theelectric bending operation device.

Note that, if evacuation of nitrogen gas from inside the fluid chamberis performed using a pump instead of using the elastic force of the airbag, it is possible to instantly perform the supply and evacuation ofnitrogen gas. As a result, switching between a state in which theinsertion portion can move forward/rearward and a state in which theinsertion portion is fixed can be smoothly performed.

Further, in the cover 6 of the above described embodiment, theflexibility of the hole covering portion 6 a and the side surfacecovering portion 6 b are different. However, the configuration of thecover is not limited thereto, and the cover may be configured as shownin FIG. 7.

In a cover 61 of the present embodiment that is illustrated in FIG. 7,the wall thickness of a hole covering portion 6 a 1 that is an elasticmember and the wall thickness of a side surface covering portion 6 b 1are substantially the same. When the hole covering portion 6 a 1 of thecover 61 is pushed inside the insertion portion inserting hole 50 a,similarly to the hole covering portion 6 a, buckling is prevented andthe pressing force of the air bag 53 can be conveyed.

Meanwhile, regarding the side surface covering portions 6 b 1, theexternal diameter dimensions of the side surface covering portions 6 b 1that are circular flanges are set to match with or to be smaller withina predetermined tolerance than the external diameter of the distal endface and the external diameter of the proximal end face of the rotarycylinder 52. The side surface covering portions 6 b 1 are bendable asindicated by the dashed lines and have an elastic force that returns theside surface covering portions 6 b 1 to their original state when anexternal force is released.

As shown in FIG. 8, the side surface covering portions 6 b 1 areprovided in the rotary cylinder 52 by attaching fixing disks 6 h asfixing portions to lids 55 a and 56 a. The fixing disks 6 h of thepresent embodiment are a flat cylindrical shape, in which a locking claw6 k that protrudes by a predetermined amount in the center direction isformed in the inner face of a peripheral wall 6 i. Meanwhile, on theouter peripheral face of the lids 55 a and 56 a is formed a peripheralgroove 6 m into which the locking claw 6 k is engageably inserted.

When attaching the cover 61 to the insertion portion inserting hole 50 aof the electric bending operation device 5, the user bends the sidesurface covering portions 6 b 1 of the cover 61 to arrange the sidesurface covering portions 6 b 1 along the peripheral face of the holecovering portion 6 a 1.

Next, the user inserts the cover 61 from either opening of the insertionportion inserting hole 50 a towards the other opening. The user thencauses the entire folding portion 6 g of the side surface coveringportions 6 b 1 to protrude from the opening at the other end of theinsertion portion inserting hole 50 a.

Thereupon, the side surface covering portions 6 b 1 that were bentreturn to the flange shape due to the elastic force of the side surfacecovering portion 6 b 1. Thereafter, the user brings the side surfacecovering portions 6 b 1 at the two ends into contact with the respectivelids 55 a and 56 a.

Subsequently, the user causes the respective locking claws 6 k of thefixing disks 6 h to face the lids 55 a and 56 a. The user then engagesthe locking claw 6 k of each fixing disk 6 h with the peripheral groove6 m of each of the lids 55 a and 56 a. At this time, the user pushes inthe relevant fixing disk 6 h against the elastic force of the sidesurface covering portion 6 b 1. As a result, the locking claw 6 k islatched in the peripheral groove 6 m to thereby attach the cover 61 tothe electric bending operation device 5, as shown in FIG. 8.

Thus, by providing peripheral grooves in the lids and also providinglocking claws that are engageably inserted into the peripheral groovesin the fixing disks, the side surface covering portions can be easilyfixed to the side surfaces of the rotary cylinder.

Note that, the above-described cover 6 and cover 61 have a configurationin which flange-shaped portions of the same shape are provided at bothside portions of the hole covering portion 6 a. However, instead ofproviding flange-shaped portions of the same shape at both side portionsof the hole covering portion 6 a, a cover 62 may be provided that isconfigured as illustrated in FIG. 9.

The cover 62 illustrated in FIG. 9 is a modification example of thecover 6. In the cover 62, a side surface covering portion 6 b 2 providedat one end side of the hole covering portion 6 a is configured as athin-walled sheet, which is a so-called drape. The side surface coveringportion 6 b 2 is formed in a size that covers the electric bendingoperation device 5. The side surface covering portion 6 b 2 is folded upprior to use. The remaining configuration of the cover 62 is the same asthe cover 6.

When attaching the cover 62 of the present embodiment to the insertionportion inserting hole 50 a of the electric bending operation device 5,the user bends the side surface covering portion 6 b 2 of the cover 62to dispose the side surface covering portion 6 b 2 along the peripheralface of the hole covering portion 6 a.

Next, the user inserts the cover 62 from one opening of the insertionportion inserting hole 50 a towards the other opening thereof. The usercauses the folding portion 6 g of the side surface covering portion 6 b2 to protrude from the opening at the other end of the insertion portioninserting hole 50 a. Thereafter, the user returns the bent side surfacecovering portion 6 b 2 to a flange shape.

Subsequently, the user unfolds the side surface covering portion 6 b 2that is folded up. The user covers the side surface covering portion 6 b2 over the electric bending operation device 5 while taking into accountthe graspability and operability of the lever 54, the graspability ofthe insertion portion operation section 30, and the operability of thefirst knob portion 31, the second knob portion 32, and the twistingoperation buttons 35.

Next, after disposing the edge portion of the side surface coveringportion 6 b 2 on a mounting portion 56 c of the lid 56 b, the userarranges the edge portion 6 e of the side surface covering portion 6 bso as to overlay the edge portion 6 e on the edge portion 6 e 2 of theside surface covering portion 6 b 2. Thereafter, the user winds thebelt-shaped fixing portion 6 c around the mounting portion and matchestogether the hook and loop fastener 6 f. As a result, as shown in FIG.10, the electric bending operation device 5 is covered with the sidesurface covering portion 6 b 2 of the cover 62.

Thus, by providing the cover with a side surface covering portion havingthe shape of a sheet that covers the entire electric bending operationdevice, it is possible to dispense with sterilization of the electricbending operation device after completing an endoscopic examination.

Although according to the above described embodiment the medicalinstrument for observation is taken to be an electric bending endoscope,the medical instrument for observation is not limited to an electricbending endoscope and, for example, may be a medical tube having anelectric bending portion that is similar to that of the above describedelectric endoscope. The medical tube is a so-called overtube that has achannel hole through which an observation probe, an illumination probe,and a manipulator are respectively inserted. The medical tube may alsobe configured to include a channel hole through which an endoscope isinserted instead of the channel hole through which an observation probeand an illumination probe are respectively inserted.

Further, according to the above described embodiment, fixing of aninsertion portion of an endoscope that is inserted through an insertionportion inserting hole of an electric bending operation device isperformed by supplying nitrogen gas to a fluid chamber of an air bag.However, a configuration that integrally fixes an insertion portion thatis inserted through the insertion portion inserting hole of the electricbending operation device is not limited to an air bag, and may be aconfiguration in which an insertion portion pressing member is a clawmember as illustrated in FIG. 11 to FIG. 14.

An electric bending operation device having an insertion portionmounting mechanism with a different configuration will now be describedreferring to FIG. 11 to FIG. 14. Note that, members that are the same asin the above described first embodiment are denoted by the samereference numerals and a description thereof is omitted below.

As illustrated in FIG. 11 and FIG. 12, an insertion portion mountingmechanism 150 of an electric bending operation device 5A according tothe present embodiment principally includes the rotation holding portion51, a rotary cylinder 152 that also serves as the rotation mechanism 70,a plurality of claw members 153 as insertion portion pressing members, apair of switching cylinders 154, an urging member 155, a movablecylinder 156, and a lever 54A. Reference numerals 158 a and 158 b denotelids. Lids 158 a and 158 b are fixed to the distal end face and theproximal end face of the rotary cylinder 152, respectively. In thepresent embodiment, the proximity switch 59 is not required.

As illustrated in FIG. 11, an inverted U-shaped arm 54 b is integrallyfixed to the lever 54A. Pressing portions 54 c are provided at both endsof the arm 54 b. When the lever 54A moves in the direction indicated bythe dashed line in FIG. 12, the pressing portions 54 c contact againstthe side surfaces on the proximal end side of an external flange 156 fprovided in the movable cylinder 156 to cause the movable cylinder 156to move with respect to the rotary cylinder 152.

As shown in FIG. 12, the rotation holding portion 51 comprises thethrough-hole 51 h. A bearing 7 a is provided inside the through-hole 51h. A rotary portion 152 a of the rotary cylinder 152 is rotatablydisposed in the bearing 7 a. The rotary cylinder 152 comprises a rotaryportion 152 a and a sliding portion 152 b on the outer peripheral facethereof. The movable cylinder 156 configuring a switching mechanism isslidingly disposed on the outer periphery of the sliding portion 152 b.

The rotary cylinder 152 has protrusions 152 c and 152 d that protrude ina central axis direction at a half-way portion and a proximal end sideof the inner peripheral face thereof. In the present embodiment, theprotrusion 152 c is formed to the rotary cylinder 152. In contrast, theprotrusion 152 d is integrally fixed to the inner peripheral face of therotary cylinder 152 by, for example, screwing or adhering from the outerperipheral face side.

The protrusion 152 d will now be described referring to FIG. 13. Notethat, the configuration of the protrusion 152 c is substantially thesame as the configuration of the protrusion 152 d. Therefore, only theconfiguration of the protrusion 152 d is described below, and adescription of the protrusion 152 c is omitted.

A through-hole 152 h through which the insertion portion 11 is insertedis formed as indicated by a dashed line in the protrusion 152 dillustrated in FIG. 13 that is provided on the distal end side. Notchedconcave portions 152 g for disposing the claw members 153 as insertionportion pressing members are provided at three places in the protrusion152 d. The three notched concave portions 152 g are provided radiallywith respect to a center O1.

The claw members 153 that are disposed in the notched concave portions152 g are attached so as to rotate in the center O1 direction with pins169 d. Reference numerals 153 a denote pressing portions that press theouter surface of the insertion portion 11 indicated by a dashed line tointegrally fix the insertion portion 11.

The arrangement positions of the claw members 153 are set so that thelongitudinal axis of the insertion portion 11 is positioned over thecenter O1 when the insertion portion 11 is fixed by the three pressingportions 153 a.

When the claw members 153 move to a position that is furthest towardsthe center O1 as indicated by a chain double-dashed line, a virtualcircle 153 b indicated by a chain double-dashed line inscribed by thethree pressing portions 153 a is formed to have predetermineddimensions, a smaller diameter than the external diameter of theinsertion portion 11.

Further, the pressing portions 153 a are configured to withdraw to aposition at which they do not contact the insertion portion 11 asindicated by the dashed line in FIG. 12 and the solid line in FIG. 13 bythe urging force of an unshown spring provided to the claw members 153in a state in which the lever 54A is grasped. When the pressing portions153 a are at the withdrawn position, the electric bending operationdevice 5A can be moved forward/rearward with respect to the insertionportion 11.

As shown in FIG. 12, at a position between the protrusion 152 c and theprotrusion 152 d provided in the rotary cylinder 152 at the innerperipheral face of the rotary cylinder 152, and at a position further onthe other end side than the protrusion 152 d, switching cylinders 154configuring respective switching mechanisms are slidingly disposed withrespect to an inner peripheral face 152 i.

The switching cylinders 154 are cylindrical, and have a pressing hole154 h in an axial direction that communicates an inner space 154 i andthe outside as shown in FIG. 14. The inner face of the pressing hole 154h is formed as a pressing face 154 p. The pressing face 154 p is formedas a tapered face in which the inner diameter dimensions graduallydecrease to a smaller diameter towards the inner space 154 i from theopening side.

Inside the pressing holes 154 h, the claw members 153 are rotatablydisposed on the protrusions 152 c and 152 d. In a state in which clawmembers 153 are disposed inside the pressing hole 154 h, the pressingface 154 p contacts against an outside surface 153 o of the claw member153 as shown by a dashed line. In this contacting state, when theswitching cylinder 154 is moved, for example, by a distance Lx from theposition of the dashed line by the urging member 155 as indicated by thesolid line, the outside surface 153 o of the claw member 153 is pressedby the pressing face 154 p accompanying the movement of the switchingcylinder 154. The pressing portion 153 a then presses the outer surfaceof the insertion portion 11 as indicated by the dashed line.

As shown in FIG. 12, the switching cylinder 154 comprises a pin hole 154din the outer peripheral face thereof. A sliding pin 169 e is integrallyfixed in the pin hole 154 dby caulking or screwing. The length of thesliding pin 169 e is set such that the sliding pin 169 e protrudes tooutside from the outer peripheral face of the sliding portion 152 b viathe long hole 152 j formed in the sliding portion 152 b of the rotarycylinder 152. The long hole 152 j is a through-hole that communicatesthe inner peripheral face and outer peripheral face of the rotarycylinder 152, and is formed parallel with the longitudinal axis of therotary cylinder 152.

The movable cylinder 156 is slidingly disposed at the sliding portion152 b of the rotary cylinder 152. The movable cylinder 156 has anexternal flange 156 f at a predetermined position of a half-way portionof the outer peripheral face thereof. A pressing portion 54 c of the arm54 b contacts against the external flange 156 f. When the lever 54A ismoved in the direction indicated by the dashed line in FIG. 12, themovable cylinder 156 moves to the distal end side. Two pin holes 156 hin which the sliding pin 169 e is disposed are formed in the movablecylinder 156. The pin holes 156 h are through-holes that communicate theinner face and outer face of the movable cylinder 156.

The urging member 155 is a helical compression spring. The urging member155 is provided between the switching cylinder 154 on the protrusion 152c side and the protrusion 152 d. In the following description, of thepair of switching cylinders 154, the switching cylinder provided on theprotrusion 152 d side is referred to as a first switching cylinder 154a, and the switching cylinder provided on the protrusion 152 c side isreferred to as a second switching cylinder 154 b.

The urging member 155 has an urging force that moves the two switchingcylinders 154 a and 154 b to the proximal end side to press theinsertion portion 11 with the pressing portions 153 a of the clawmembers 153 to integrally fix the insertion portion 11. Thus, when thesecond switching cylinder 154 b is moved by the urging force of theurging member 155, the two switching cylinders 154 a and 154 b move inan integrated state to the proximal end side as shown in FIG. 14.

In the electric bending operation device 5A configured as describedabove, the cover 6 is mounted to the insertion portion inserting hole 50a comprising the through-hole 152 h of the protrusion 152 c, the innerspace 154 i of the second switching cylinder 154 b, the through-hole 152h of the protrusion 152 d, and the inner space 154 i of the switchingcylinder 154 a.

At that time, the user mounts the cover 6 by moving the lever 54A fromthe position indicated by the solid line to the position indicated bythe dashed line as shown in FIG. 12, and maintaining the pressingportions 153 a of the claw members 153 at the withdrawn positionsindicated by dashed lines. As a result, the hole covering portion 6 a ofthe cover 6 is disposed in the insertion portion inserting hole 50 a asdescribed above, and the side surface covering portions 6 b of the cover6 are respectively disposed via unshown fixing disks at the side surfaceof the lid 55 that is the distal end face of the rotary cylinder 152 andthe side surface of the lid 56 comprising the proximal end face of therotary cylinder 152.

Next, the user holds the lever 54A at the position indicated by thedashed line and inserts the insertion portion 11 of the electric bendingendoscope 2 through the insertion portion inserting hole 50 a of theelectric bending operation device 5A to which the cover 6 is mounted. Atthis time, the user inserts the insertion portion 11 into thethrough-hole 6 d of the hole covering portion 6 a configuring the cover6.

When the electric bending operation device 5A reaches a predeterminedposition of the flexible tube portion 16, the user releases the handthat is holding the lever 54A to release the held state. Thereupon, thetwo switching cylinders 154 a and 154 b move to the proximal end sideunder the urging force of the urging member 155. The pressing portions153 a of the claw members 153 then press the flexible tube portion 16via the hole covering portion 6 a such that the rotary cylinder 152 ofthe electric bending operation device 5A and the flexible tube portion16 are integrally fixed together.

Thus, when pressing the insertion portion with pressing portions of clawmembers as insertion portion pressing members, the hole covering portionof the cover that informed with an elastic member is disposed betweenthe insertion portion and the pressing portions of the claw members.Consequently, in comparison to a case in which a pressing portiondirectly presses the insertion portion, since the elastic member isprovided between the pressing portions and the insertion portion, thepressing force of the pressing portion with respect to the insertionportion increases and a firm fixing force can be obtained. The otheractions and advantages are the same as in the above describedembodiment.

A second embodiment of the present invention will now be describedreferring to FIG. 15 and FIG. 16.

The cover of the present embodiment also serves as an insertion portionpressing member. A cover 63 illustrated in FIG. 15 is an elastic memberand includes a clamp portion 6 p, a side surface covering portion 6 b 1,and a short connecting portion 6 r 1 and a long connecting portion 6 r 2that connect the clamp portion 6 p and the side surface covering portion6 b 1. The cover 63 includes a through-hole 6 d that configures theinsertion portion inserting hole 50 a.

As shown in FIG. 16, an insertion portion mounting mechanism 150A of thepresent embodiment has a configuration in which, similarly to theelectric bending operation device 5A, a movable cylinder 156 and apressing cylinder 154C move in an integrated manner with respect to therotary cylinder 152 by operating the lever 54A.

A recess 154 e that is thinned-down is formed in the pressing cylinder154C. The recess 154 e and the outside are linked by a hole 154 f. Thepressing cylinder 154C is urged to the proximal end side by an urgingmember 155A.

A rotary cylinder 152 of the present embodiment includes a hollowportion 201, a cover retaining hole 202, and an insertion portionintroduction hole 203. The insertion portion introduction hole 203 is athrough-hole, and communicates the hollow portion 201 comprising thecover retaining hole 202 and the outside. Reference numerals 55 a and 56a denote lids. The lids 55 a and 56 a are respectively fixed to thedistal end face and the proximal end face of the rotary cylinder 152.

The inner diameter of the insertion portion introduction hole 203 isformed with dimensions that allow the short connecting portion 6 r 1 ofthe cover 63 to freely fit therein. The end on the short connectingportion 6 r 1 side of the clamp portion 6 p is disposed in the coverretaining hole 202. The inner diameter of the cover retaining hole 202is set to be greater by a predetermined clearance amount with respect tothe external diameter dimensions of the clamp portion 6 p. The innerdiameter of the hole 154 f of the pressing cylinder 154C is formed withdimensions that allow the long connecting portion 6 r 2 to freely fittherein. The urging member 155A is disposed between the lid 55 a and thepressing cylinder 154C. The pressing cylinder 154C is urged in theproximal end direction of the long hole 152 j by the urging force of theurging member 155A.

The remaining configuration is the same as that of the electric bendingoperation device 5A, and the same members are denoted by the samereference numerals and a description thereof is omitted below.

Note that the electric bending operation device 5B, though not shown inthe drawings, is configured by mounting the insertion portion mountingmechanism 150A shown in FIG. 16 to the support column, instead of theinsertion portion mounting mechanism 150 of the electric bendingoperation device 5A in FIG. 11.

When using the electric bending operation device 5B, the user disposesthe cover 63 inside the hollow portion 201 of the electric bendingoperation device 5B. At that time, the user bends the side surfacecovering portion 6 b 1 of the cover 63 to dispose the side surfacecovering portion 6 b 1 along the peripheral face of the short connectingportion 6 r 1.

Next, the user inserts the side surface covering portion 6 b 1 and theshort connecting portion 6 r 1 of the cover 63 into the hollow portion201 through an opening 6 s of the fixing disk 6 h and an opening 6 o ofthe lid 55 a. Thereupon, the clamp portion 6 p contacts against the lid55 a.

In this case, the user moves the lever 54A to the dashed line position.Thereupon, the pressing cylinder 154C approaches the lid 55 a sideagainst the urging force of the urging member 155A. Maintaining thisstate, the user inserts the clamp portion 6 p through the inside of thehollow portion 201 through the opening 6 s of the fixing disk 6 h andthe opening 6 o of the lid 55 a.

At this time, the user pushes forward the clamp portion 6 p whilesquashing the clamp portion 6 p to insert the clamp portion 6 p into thehole 154 f inside the hollow portion 201. When the clamp portion 6 p isinserted through the hole 154 f, the user pushes forward the clampportion 6 p to pass the clamp portion 6 p through the hole 154 f.

Thereafter, the user disposes the end of the clamp portion 6 p in thecover retaining hole 202 and inserts the end into the insertion portionintroduction hole 203. Thereupon, after the side surface coveringportion 6 b 1 and the short connecting portion 6 r 1 are protruded fromthe opening of the cover retaining hole 202, the side surface coveringportion 6 b 1 and the short connecting portion 6 r 1 are disposed at theopening 6 s of the fixing disk 6 h.

In this case, the user takes out the side surface covering portion 6 b 1from inside the opening 6 s and disposes the side surface coveringportion 6 b 1 in the lid 56 a. The user then mounts the fixing disk 6 hto the lid 55 a. Thereafter, the user releases the held state of thelever 54A.

As a result, as shown in FIG. 16, the pressing cylinder 154C is urged inthe proximal end direction by the urging force of the urging member 155Aand presses the clamp portion 6 p. The clamp portion 6 p thereby entersa state in which the clamp portion 6 p presses the insertion portion.

In the electric bending operation device 5B provided with the cover 63,the through-hole 6 d of the cover 63 is the insertion portion insertinghole 50 a. Therefore, in order to insert the insertion portion 11 intothe insertion portion inserting hole 50 a, the user holds the lever 54Aat the position indicated by the dashed line shown in FIG. 12 to placethe clamp portion 6 p in an unloaded state. As a result, the cover 63including the clamp portion 6 p changes shape in the manner illustratedby the dashed line. That is, the through-hole 6 d enters an extendedstate.

The user inserts the insertion portion 11 of the electric bendingendoscope 2 into the through-hole 6 d. When the electric bendingoperation device 5B reaches a predetermined position of the flexibletube portion 16, the user releases the hand that holds the lever 54A torelease the held state. Thereupon, the two pressing cylinders 154C aremoved to the proximal end side by the urging force of the urging member155A and press the clamp portion 6 p. Thereby, the clamp portion 6 p isagain compressed in the longitudinal axis direction and the innerdiameter of the through-hole 6 d changes to a small diameter. As aresult, the clamp portion 6 p presses the insertion portion 11 tointegrally fix together the insertion portion 11 and the rotary cylinder152 of the electric bending operation device 5B″.

Thus, by having the cover also serve as an insertion portion pressingmember, the configuration can be simplified. The other actions andadvantages are the same as in the above described embodiment.

A third embodiment of the present invention will now be describedreferring to FIG. 17 to FIG. 20.

The electric bending operation device of the present embodiment can bemounted to an insertion portion of an endoscope in a state in which theinsertion portion is inserted inside the body.

An electric bending operation device 5C illustrated in FIG. 17 and FIG.18 includes a device main body 210 that can be divided into two pieces.The device main body 210 includes an upper structure pipe 211 and alower structure pipe 212. The upper structure pipe 211 and the lowerstructure pipe 212 are each formed in a half-pipe shape, and areconfigured to be openable and closable by means a hinge 213. A lockinggroove 214 is formed in the upper structure pipe 211, and a locking claw215 that is engageably inserted into the locking groove 214 is formed inthe lower structure pipe 212.

On the inner peripheral face of the lower structure pipe 212 arearranged, for example, two driven rollers 216. A long hole 217 that iselongated in the axial direction is formed in the top face of the upperstructure pipe 211. A rotation operation lever 218 is pivotallysupported in a rotatable condition on the longitudinal side surface ofthe long hole 217. The rotation operation lever 218 is pulled and tiltedin the direction of an arrow A by a spring 219. Therefore, a drivingroller 222, described later, is normally in a non-contacting state withrespect to the insertion portion. A motor cover 220 is provided at oneend of the rotation operation lever 218.

An insertion portion rotation motor 221 is provided inside the motorcover 220. A driving roller for rotating the insertion portion(hereafter, abbreviated as “driving roller”) 222 is fixedly installed ona motor shaft of the insertion portion rotation motor 221. At one end ofthe rotation operation lever 218 is formed a notch 223 for providing theroller 222 therein.

Reference numeral 224 denotes a rotation operation switch. The rotationoperation switch 224 is configured such that when the surgeon tilts therotation operation switch 224 in the direction of an arrow B, theinsertion portion 231 rotates in a counter-clockwise direction as viewedby the surgeon, and when the surgeon tilts the rotation operation switch224 in the direction of an arrow C, the insertion portion 231 rotates ina clockwise direction as viewed by the surgeon.

As shown illustrated in FIG. 19, a drape 225 has a so-called rectangularshape in which a pasting margin 226 is provided at both short side endsand at one long side end. The length of the short side of the drape 225in a state in which the long side of the drape 225 and the longitudinalaxis of the insertion portion of the endoscope are parallelly disposedis a length that can be wrapped around the insertion portion 231 atleast 1.5 times in the circumferential direction of the insertionportion 231 as shown in FIG. 20. The length of the long side of thedrape 225 is sufficiently long with respect to the length of the devicemain body 210.

A case will now be described in which the electric bending operationdevice 5C is used, for example, in a transrectal endoscopic examination.

During the examination, when a surgeon requires the electric bendingoperation device 5C, the user pastes the drape 225 to a desired positionof the insertion portion 231 as shown in FIG. 21 that is exposed on theside of the user's hands from the anus.

Next, the user affixes the pasting margin 226 of the drape 225 on theinsertion portion 231 that is exposed on the user's hands side to thedevice main body 210. More specifically, as shown in FIG. 22, the userplaces the upper structure pipe 211 and the lower structure pipe 212 inan open state, and inserts a drape winding section 232 of the insertionportion 231 between the upper structure pipe 211 and the lower structurepipe 212.

In this case, the user aligns the drape winding section 232 so that thedrape winding section 232 is disposed in a predetermined state withrespect to three rollers 216, 216, and 222. The user then checks themounting state and the positional relationship of the drape windingsection 232 and the three rollers 216, 216, and 222, and engageablyinserts the locking claw 215 in the locking groove 214.

As a result, the insertion portion is exposed from the device main body210 in which the upper structure pipe 211 and the lower structure pipe212 are united. In this case, the user folds the drape 225 at a positionpartway along the short side of the drape 225 and pastes and fixes thepasting margin 226 to an end of the device main body. Thus, attachmentof the electric bending operation device 5C to the insertion portion 231is completed.

Note that, the drape 225 has a sufficient length and looseness withrespect to the length of the device main body 210. Therefore, even whenthe insertion portion 231 rotates, the drape 225 is not pulled,stretched, or torn by the influence of the insertion portion 231.Further, the rollers 216 and 222 are formed with an elastic member suchas rubber.

When mounting of the electric bending operation device 5C is completed,the surgeon grasps the device main body 210 and carries out theinsertion of the insertion portion 231. When rotating the insertionportion 231, the surgeon draws back the rotation operation lever 218 tothe side of the surgeon's hands against the urging force of the spring219. Thereupon, the driving roller 222 contacts against the drapewinding section 232 and, further, by returning the rotation operationlever 218 to the surgeon's hand side, the rotation of the driving roller222 is transmitted to the drape winding section 232. As a result, theinsertion portion 231 performs a twisting operation.

When insertion of the insertion portion 231 as far as the target site iscompleted, the surgeon removes the pasting margin 226 on the short sideof the drape 225 from the device main body 210, and detaches the devicemain body 210 from the insertion portion.

Thereafter, the surgeon grasps the insertion portion 231 from which thedevice main body 210 is detached and carries out the examination. If itis necessary to again mount the electric bending operation device 5C onthe insertion portion 231, the user mounts the electric bendingoperation device 5C to the insertion portion 231 by the above describedprocedure.

Thus, the device main body is configured to be openable and closable.After putting the upper structure pipe and the lower structure pipe thatcomprise the device main body in an open state and disposing the drapeinsertion portion inside the device main body, the respective ends ofthe drape are pasted to the respective ends of the device main body. Itis thus possible to mount the device main body to the insertion portionof an endoscope during use.

Further, by attaching the drape insertion portion on which the drape ismounted to the device main body, it is possible to prevent the devicemain body from being contaminated by dirt or the like that adheres tothe insertion portion.

Furthermore, since the configuration is one in which the driving rolleris brought into close contact with the insertion portion with the drapelocated therebetween and rotated, a driving force can be transferred tothe insertion portion more effectively than a case in which the drivingroller directly presses on the insertion portion.

According to the present invention, the medical operation device isdescribed mainly taking the case of an electric bending operationdevice. However, the medical operation device is not limited to anelectric bending operation device.

Having described the preferred embodiments of the invention referring tothe accompanying drawings, it should be understood that the presentinvention is not limited to those precise embodiments and variouschanges and modifications thereof could be made by one skilled in theart without departing from the spirit or scope of the invention asdefined in the appended claims.

1. A medical operation device including: a rotary cylinder that includes an insertion portion inserting hole through which an insertion portion of a medical instrument for observation is inserted, the rotary cylinder being rotatably provided on a device main body; an insertion portion pressing member that presses the insertion portion of the medical instrument for observation which is inserted through the insertion portion inserting hole, to thereby pressingly fix the insertion portion with respect to the rotary cylinder, the insertion portion pressing member being provided inside the rotary cylinder; an insertion portion mounting section cover that is provided inside the insertion portion inserting hole and that prevents the insertion portion which is inserted through the insertion portion inserting hole from directly touching an inner face of the insertion portion inserting hole, a vicinity of an opening of the insertion portion inserting hole, and the insertion portion pressing member; and a switching instruction portion that switches whether or not the insertion portion pressing member presses an outer surface of the insertion portion via the insertion portion mounting section cover and specifies a state in which the insertion portion is fixed to the rotary cylinder and a state in which the insertion portion moves forward/rearward with respect to the rotary cylinder, wherein the insertion portion mounting section cover includes: an inserting hole inner surface covering portion that covers a whole inner circumference of the insertion portion inserting hole and also an insertion portion pressing portion of the insertion portion pressing member, and has a through hole through which the insertion portion can be inserted; a rotary portion side surface covering portion that is provided on at least one end side of the inserting hole inner surface covering portion and that covers a side surface of the rotary cylinder in which an opening of the insertion portion inserting hole is formed; and a fixing portion that fixes the rotary portion side surface covering portion to the rotary cylinder.
 2. The medical operation device according to claim 1, further including a rotation mechanism that rotates the rotary cylinder for performing a twisting operation in the state in which the insertion portion is fixed to the rotary cylinder by being pressed by the insertion portion pressing member.
 3. The medical operation device according to claim 2, wherein when the device main body is rotated relative to the rotary cylinder by the rotation mechanism, the rotary cylinder appears not to be rotating as observed from a viewpoint of an operator.
 4. The medical operation device according to claim 1, wherein the insertion portion mounting section cover is formed by a member having flexibility.
 5. The medical operation device according to claim 1, wherein the inserting hole inner surface covering portion of the insertion portion mounting section cover is a member in a pipe shape that has flexibility and the rotary portion side surface covering portion is a member in a flange shape having flexibility, and wherein the flexibility of the inserting hole inner surface covering portion is greater than the flexibility of the rotary portion side surface covering portion.
 6. The medical operation device according to claim 1, wherein the inserting hole inner surface covering portion of the insertion portion mounting section cover can be pushed into the insertion portion inserting hole and has a flexibility that is capable of conveying a pressing force of the insertion portion pressing member. 